| NPI | 1245227628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: PA MD427602) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 200001269) |
| 208600000X Surgery (Licence: PA MD427602) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: VA 0101237914) | |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2024-01-03 |